Valley News – Police: Death investigation at DHMC was triggered by a nurse’s suspicions

LEBANON — Authorities treated the January death of an East Corinth woman at Dartmouth-Hitchcock Medical Center as a possible homicide after hospital employees raised concerns that family members had tampered with the woman’s pain medication, according to Lebanon Police Department reports.

One nurse went as far as to tell police that she believed the woman may have been “intentionally overdosed” with fentanyl, a powerful painkiller that has been associated with the opioid epidemic.

But a subsequent autopsy showed those concerns were unfounded, and the Jan. 27 death of 67-year-old Susan Massey — who was suffering from an undisclosed terminal condition — was natural and a result of complications of disease.

“Her narcotic levels (were) within the normal, expected range,” a Lebanon police officer, one of at least six who responded to the hospital, wrote in a report.

When the Attorney General’s Office publicly released the autopsy findings in late April, officials declined to offer any details about the case except for Massey’s name.

DHMC consistently has declined to offer any explanation for the episode, asserting they are prohibited by law from discussing specific patients’ care without their consent, and by hospital policy from discussing personnel matters.

Meanwhile, the six Lebanon police reports, redacted versions of which were released to Valley News under a public records request, provide an account of how law enforcement — including the state’s Major Crime Unit — came to investigate Massey’s death as a “possible homicide” rather than the inevitable demise of a hospitalized woman who was in decline.

The police reports give the following account:

On Friday, Jan. 25, doctors had determined that Massey should enter into palliative care, where death is thought to be imminent, life-sustaining treatments are withdrawn and the only medications provided are to keep a patient as comfortable as possible.

Doctors had told Massey’s relatives that she could be dead within hours, but she unexpectedly survived through Sunday morning.

Over the weekend, a nurse told a supervisor that Massey’s relatives — including two DHMC employees — had become agitated about her lingering condition and had been aggressive about demanding a higher dose of pain medication.

The caregivers also discussed concerns that the relatives may do something to hasten Massey’s death. The boxes that hold medications such as fentanyl while they are being dispensed are locked with a four-digit code but all the boxes at DHMC use the same code. (At one point, a doctor approached Massey’s relatives to discourage them from interfering in her care, and the relatives denied doing so.)

On Sunday, Jan. 27, Massey’s caregivers agreed to provide fentanyl through an intravenous drip, according to police. A fentanyl IV — a 50 mL dose meant to be administered gradually over as many as 100 hours — was hung in Massey’s room around 8 a.m.

The nurse told police that about an hour later when she returned to Massey’s room, the bag of fentanyl was nearly empty and the door was ajar on the secure box where it was hanging.

While the nurse was concerned that the bag of fentanyl had been emptied so quickly, she hung a new bag so the medication would continue to be administered as prescribed.

Massey died later that day around 12:30 p.m.

It wasn’t until about three hours later that a DHMC security officer called police to report a possible homicide and 44 mL of missing fentanyl.

Lebanon officers responded to the scene in the intensive care unit that afternoon. Massey’s family had left the hospital by the time officers arrived and police focused their investigation on interviews with DHMC staff.

The officers interviewed Massey’s nurse, who shared her suspicions about the relatives with police. She also told police that she had followed DHMC’s protocol for handling powerful medications such as fentanyl. The nurse said she requested an even more secure lockbox to house the fentanyl so that it “couldn’t be tampered with,” but it hadn’t arrived in the room yet when the first bag was hung.

Police interviewed the nurse’s manager, who also said the family had been aggressive with staff members about Massey’s care.

Police also spoke to a colleague who had helped Massey’s nurse hang the first bag of fentanyl, according to the reports. That colleague told police the nurse initially used the wrong tubing and that some of the medication, perhaps 3 to 6 mL, had been “wasted” when the tubing was switched.

After completing their interviews, Lebanon police contacted State Police who in turn called the state Attorney General’s Office to report a possible homicide and 44 mL of missing fentanyl, and detectives from the Major Crimes Unit took over the investigation.

The six Lebanon police officers who wrote reports in the case were Sgt. Richard Norris, who was in charge of the department’s investigation for the local agency, officer Eric Hunter, Corporal Garrett Hubert, detective Callie Barrett, Lt. Richard Smolenski and officer Daniel Gaspard.

All of their reports are similar in that they give each officer’s account of the afternoon of Jan. 27. The names of the individuals associated with the case are listed on the cover sheet, but those names are blacked out in the body of each report.

While the report from Smolenski makes it clear that Massey had not been the victim of an intentional overdose, just what happened to the supposedly “missing” fentanyl isn’t made clear.

On Monday, Assistant Attorney General Ben Agati said his office is still reviewing reports from the case and could not release any further details.

“We are working to find that answer at this point, but I don’t have it yet,” Agati said.

In its news release last month, the Attorney General’s Office said it is not unusual for an agency to “receive reports of witnessed or unattended deaths that cannot quickly and easily be identified as a natural, accidental or suicidal death.”

Lebanon Police Chief Richard Mello referred questions about the case to Agati. The department initially responded to the Massey case because the circumstances surrounding her death seemed “a little unusual” at the time, he said.

Phone messages left for two of Massey’s family members weren’t returned.

On Monday, a DHMC spokesman declined to address specific questions about the Massey case.

Jordan Cuddemi can be reached at jcuddemi@vnews.com or 603-727-3248.